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Background/aim: Results of epidemiological studies concerning the association between smoking and alcohol use and gallstone risk are inconsistent. We examined the relation of smoking and alcohol use to gallstone disease in Japanese men., Methods: We investigated 174 cases having gallstones as determined by ultrasonography, 104 cases of postcholecystectomy state, and 6,906 controls having a normal gallbladder in the consecutive series of 7,637 men aged 48-59 years receiving a retirement health examination at four hospitals of the Self-Defense Forces from 1986 to 1994. Fifty men had been aware of having gallstones. Known gallstones and postcholecystectomy state were combined as known gallstone disease. Smoking and drinking habits were ascertained by a self-administered questionnaire. Statistical adjustment was made for body mass index, glucose tolerance status, Self-Defense Forces rank, hospital, and either cigarette smoking or alcohol use., Results: Cigarette smoking was not measurably associated with either prevalent gallstones or postcholecystectomy state, nor with either newly diagnosed gallstones or known gallstone disease. Alcohol use was related to a significant decrease in the prevalence odds of both gallstones and postcholecystectomy state, and the decrease was slightly more profound for known gallstone disease., Conclusions: Cigarette smoking is probably unrelated to the gallstone risk, and alcohol consumption seems to confer protection against gallstone formation., (Copyright 2002 S. Karger AG, Basel)

Alcohol drinking as well as cigarette smoking has been associated with development of colorectal polyps, Asians such, as Japanese, Chinese and Korean have high frequency of genetic polymorphism in low Km aldehyde dehydrogenase (ALDH2) gene which greatly regulates alcohol intake. In the present study, we investigated associations of this polymorphism and lifestyles with colorectal polyps in self-defense forces personnels in Japan. All subjects received colonoscopy at a retirement health examination. The ALDH2 genotype was determined using polymerase chain reaction and restriction fragment length polymorphism method. Frequency of the ALDH2 genotype was not different between those with colorectal polyps (n=69) and those without the polyps (n=131). Smoking was associated with development of colorectal polyps (OR=4.7, 95% confidence interval=1.9-11.5) in the ALDH2 proficient genotype. The association appeared to be enhanced by drinking alcohol since a synergistic effect of smoking and alcohol drinking (> or =60 ml/day) was indicated (OR=9.9, 95% confidence interval=2.9-34.1) by logistic regression analysis. In the ALDH2 deficient genotype, however, we could not evaluate interactions of smoking and alcohol drinking on colorectal polyp development because of the small sample size of heavy alcohol drinkers. The genotype analysis would be useful in evaluating effects of environmental factors on outcomes for each genetically defined subpopulation.

Subjective health and alcohol intake are important predictors of mortality. There have been few epidemiological studies, however, of the relationship between alcohol consumption and subjective health among the Japanese. The purpose of this study is to investigate the association between alcohol consumption and subjective health. The study subjects were 2,020 Japanese male employees, who were free from serious disease conditions. The data on subjective health and alcohol consumption were obtained by means of self-reported questionnaire. The subjects who responded "poor health" in the answer to the question about the subjective health status were considered to be in ill-health. Ethanol intake per day was calculated by multiplying the frequency of drinking by the ethanol intake per drinking occasion and summing up for each alcoholic beverage. Age, smoking status, physical activity, and sleeping hours were treated as confounding factors. As a result, subjects who consumed 25-36 or 49 g ethanol or more per day had a significantly lower risk of self-rated ill-health compared with those who had never drunk, and a significantly inverse trend was found independent of age, smoking status, physical activity, and sleeping hours. In conclusion, moderate drinkers have a lower risk of self-rated ill-health among Japanese male employees investigated.

We investigated the relationship of cigarette smoking, alcohol use, recreational exercise and obesity with serum lipid atherogenicity because of paucity of epidemiological studies. The subjects were 2,228 male officials of the Self-Defense Forces in Japan, who were aged 49-55 years and received a preretirement health examination in the period from 1991 to 1992. A self-administered questionnaire was used to ascertain cigarette smoking, alcohol use and recreational exercise. Serum total cholesterol (TC) and low-density-lipoprotein cholesterol (LDL-C) were increased with increasing levels of body mass index (BMI) and waist-to-hip ratio (WHR), and decreased with increasing levels of cigarette smoking and alcohol use. Serum high-density-lipoprotein cholesterol (HDL-C) was positively associated with alcohol use and recreational exercise, and negatively associated with cigarette smoking, BMI and WHR. BMI and alcohol use were most strongly associated with both LDL-C/HDL-C and TC/HDL-C ratios with BMI in an atherogenic direction and alcohol use in an antiatherogenic direction. Recreational exercise was weakly associated with less atherogenic lipid profile. BMI was the strongest determinant of serum lipid atherogenicity whereas alcohol use was most antiatherogenic. WHR was less important than BMI in the determination of serum lipid atherogenicity in Japanese men.

We investigated the independent associations of total and beverage-specific ethanol consumption with body mass index (BMI) and waist-to-hip ratio (WHR) in middle-aged Japanese males, because of the scarcity of epidemiologic data in Japan. The subjects were 2227 male self-defense officials who received a pre-retirement health examination at the Self-Defense Forces Fukuoka, Kumamoto, and Sapporo Hospitals. Data on alcohol intake, smoking, physical activity, and past medical history were obtained from a self-reported questionnaire. Height, weight, and waist and hip girth measurements were obtained at the examination. Multiple linear regression analysis was employed. Alcohol intake was positively and strongly associated with WHR (p = 0.0001), but not associated with BMI after adjustment for lifestyle variables, including either BMI or WHR. Subjects who consumed 15 ml per day or more of shochu ethanol showed a larger WHR than never drinkers, and a dose-response relationship was found. Dose-response relationships to other beverages were not found. Dose-response relationships to other beverages were not found. These findings suggest that alcohol intake is strongly and independently associated with WHR, but not with BMI. Abdominal obesity was positively associated with shochu ethanol, but not with other types of alcohol.

The relationship between cigarette smoking, alcohol use, and dietary factors and the risk of adenomas of the sigmoid colon was examined in male self-defense officials who received a preretirement health examination at three Self-Defense Forces hospitals in Japan. In the comparison between 228 patients with sigmoid adenomas and 1484 control subjects with normal colonoscopy findings (> or = 60 cm from the anus), a clear dose-response relationship was observed between cigarette smoking and risk of adenoma. After adjustment for rank, body mass index, alcohol use, and physical activity as well as for hospital and survey season, the odds ratios (and 95% confidence intervals (CIs)) for the categories of 0, 1 to 399, 400 to 799, and 800 or more cigarette-years were 1.0, 2.1 (1.2 to 3.5), 2.8 (1.8 to 4.3), and 3.5 (2.1 to 5.8), respectively. Current alcohol drinkers tended to have an increased risk, but without a dose-response relation. Among four types of alcoholic beverages (shochu, sake, beer, and whiskey), only whiskey showed a weak association with risk of adenoma. None of the 13 dietary items studied (including meat and rice consumption) was measurably associated with adenoma risk. The present findings provide additional evidence that cigarette smoking is a risk factor for colon adenomas. It is inconclusive regarding alcohol intake's association with adenoma risk.

We conducted a case-control study, using 429 cases with histologically confirmed sigmoid adenoma, 75 cases with rectal adenoma, and 3101 controls showing normal colonoscopy at least up to 60 cm from the anus. The subjects were male Self-Defense Forces personnel aged 48-56 who received a retirement health examination including a routine sigmoid- or colonoscopy. Lifestyle characteristics were ascertained by a self-administered questionnaire. Smoking in the recent past (< or = 10 years preceding the colonoscopy) and smoking in the remote past (> 10 years before the colonoscopy) were both significantly associated with risk of sigmoid adenoma but not with rectal adenoma as a whole. After reciprocal adjustment for smoking in the two periods, only smoking in the recent past was associated with both sigmoid colon and rectal adenomas. Odds ratios (OR) of sigmoid adenoma (and 95% confidence interval) for the categories of 0, 1-150, 151-250 and > or = 251 cigarette-years were 1.0 (reference), 1.9 (1.3-2.8), 2.1 (1.4-3.0) and 3.0 (1.9-4.7), respectively (P for trend < 0.01), and those for rectal adenoma were 1.0 (reference), 1.2 (0.4 3.2), 3.5 (1.4-8.5) and 2.0 (0.6 6.7), respectively (P for trend = 0.03). Alcohol use was significantly positively associated with sigmoid adenoma, and insignificantly associated with rectal adenoma. Body mass index was significantly positively associated with sigmoid adenoma, especially large ones. No such association was found for rectal adenoma. These findings suggest that smoking, especially in the recent past, and alcohol use are common risk factors for sigmoid colon and rectal adenomas while obesity may be exclusively related to the growth of sigmoid adenoma.

Background: Risk factors for gallstones are not fully understood, especially in men. Obesity and other risk factors for gallstone disease were investigated in Japanese men based on gallbladder ultrasonography., Methods: Forty-one men with gallstones, 31 with postcholecystectomy state, and 2044 with a normal gallbladder were identified among 2228 men aged 49-55 years who received a retirement health examination at three hospitals of the Japan Self-Defense Forces between 1991 and 1992. Glucose tolerance was determined with a 75-g oral glucose tolerance test., Results: Body mass index was not associated with gallstones, although it was significantly, positively related to postcholecystectomy. Waist to hip circumference ratio tended to be weakly associated with gallstones. Diabetes mellitus was associated only with postcholecystectomy. Smoking, alcohol intake, and physical activity were not measurably related to either gallstones or postcholecystectomy., Conclusions: The present study failed to substantiate an association of gallstone risk with either obesity or any other risk factor. Further observation is needed in view of the limited study power.